A Randomized Proof-of-Concept Study of Gamified Rhythmic Training in Autistic Children

Autistic children often experience differences in rhythmic skills and executive functioning, which are associated with rhythm-related challenges and the degree of autistic traits. Training rhythmic skills could support autistic individuals, given the fundamental role of timing skills in various aspects of cognitive, motor, and social functioning. We evaluated the feasibility of rhythmic training to support perceptual, motor, and cognitive functioning by testing Rhythm Workers (RW), a finger-tapping serious game, in autistic children (ages 7-13; n = 26). Participants were randomly assigned to play either RW or a control game with similar auditory-motor demands over 2 weeks. Feasibility results showed high compliance (retention, adherence) and similar engagement (training duration, enjoyment, perceived difficulty) for both games. Compared to the control group, children who played RW showed greater improvement in rhythmic skills as a function of training duration and autistic traits (social awareness). Gains were also observed in composite scores of executive functioning (accuracy), though not all subcomponent tasks showed significant effects. These findings offer preliminary support for the feasibility of implementing digital gamified rhythmic training for autistic children, and suggest potential benefits for motor and cognitive engagement that warrant further investigation.